1. A. Subject to the availability of federal funds, HCBS are covered services if provided to a member residing in the member’s own home or an alternative residential setting. Room and board services are not covered in a HCBS setting.
2. B. The case manager shall authorize and specify in a case management plan any additions, deletions, or changes in home and community based services provided to a member or in accordance with R9-28-510.

3. C. Home and community based services include the following:

   1. 1. Home health services provided on a part‑time or intermittent basis. These services include:

      1. a. Nursing care;
      2. b. Home health aide;
      3. c. Medical supplies, equipment, and appliances;
      4. d. Physical therapy;
      5. e. Occupational therapy;
      6. f. Respiratory therapy; and
      7. g. Speech and audiology services;
   2. 2. Private duty nursing services;
   3. 3. Medical supplies and durable medical equipment, including customized DME, as described in 9 A.A.C. 22, Article 2;
   4. 4. Transportation services to obtain covered medically necessary services;

   5. 5. Adult day health services provided to a member in an adult day health care facility licensed under 9 A.A.C. 10, Article 5, including:

      1. a. Supervision of activities specified in the member’s care plan;
      2. b. Personal care;
      3. c. Personal living skills training;
      4. d. Meals and health monitoring;
      5. e. Preventive, therapeutic, and restorative health related services; and
      6. f. Behavioral health services, provided either directly or through referral, if medically necessary;
   6. 6. Personal care services;
   7. 7. Homemaker services;
   8. 8. Home delivered meals, that provide at least one-third of the recommended dietary allowance, for a member who does not have a developmental disability under A.R.S. § 36-551;
   9. 9. Respite care services for no more than 600 hours per benefit year;

   10. 10. Habilitation services including:

       1. a. Physical therapy;
       2. b. Occupational therapy;
       3. c. Speech and audiology services;
       4. d. Training in independent living;
       5. e. Special development skills that are unique to the member;
       6. f. Sensory‑motor development;
       7. g. Behavior intervention; and
       8. h. Orientation and mobility training;

   11. 11. Developmentally disabled day care provided in a group setting during a portion of a 24-hour period, including:

       1. a. Supervision of activities specified in the member’s care plan;
       2. b. Personal care;
       3. c. Activities of daily living skills training; and
       4. d. Habilitation services;
   12. 12. Supported employment services provided to a member in the ALTCS transitional program under R9-28-306 who is developmentally disabled under A.R.S. § 36-551.

Historical Note

Adopted effective September 22, 1997 (Supp. 97-3). Amended by final rulemaking at 8 A.A.R. 2356, effective May 9, 2002 (Supp. 02-2). Amended by exempt rulemaking at 17 A.A.R. 1876, effective October 1, 2011 (Supp. 11-3). Exemption to amend rules to expire December 31, 2013 under Laws 2012, Chapter 299, Section 8 therefore this Section was amended by final rulemaking at 19 A.A.R. 2758, effective October 8, 2013 (Supp. 13-3).